Functional Outcomes After Critical Pathway for Inpatient Rehabilitation of Total Knee Arthroplasty
Objective To investigate functional outcomes after the application of a critical pathway for inpatient rehabilitation of total knee arthroplasty (TKA). Methods A total of 184 patients (57 males and 127 females; average age, 71.5±5.9 years) who underwent unilateral or bilateral TKA were included. The...
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| Format: | Article |
| Language: | English |
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Korean Academy of Rehabilitation Medicine
2019-12-01
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| Series: | Annals of Rehabilitation Medicine |
| Subjects: | |
| Online Access: | http://www.e-arm.org/upload/pdf/arm-2019-43-6-650.pdf |
| _version_ | 1797764197186011136 |
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| author | Jong Hyun Kim Bo Ryun Kim Sang Rim Kim Eun Young Han Kwang Woo Nam So Young Lee Won Bin Kim |
| author_facet | Jong Hyun Kim Bo Ryun Kim Sang Rim Kim Eun Young Han Kwang Woo Nam So Young Lee Won Bin Kim |
| author_sort | Jong Hyun Kim |
| collection | DOAJ |
| description | Objective To investigate functional outcomes after the application of a critical pathway for inpatient rehabilitation of total knee arthroplasty (TKA). Methods A total of 184 patients (57 males and 127 females; average age, 71.5±5.9 years) who underwent unilateral or bilateral TKA were included. The critical pathway included early, intensive individualized rehabilitation exercises. Patients completed the following performance-based physical function tests: the stair climbing test (SCT), 6-minute walk test (6MWT), and Timed Up and Go test (TUG) as well as measurement of isometric knee flexor and extensor strength of the operated knee, gait speed, and range of knee flexion and extension. Self-reported physical function and pain were measured using the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS), respectively, and self-reported quality of life was measured using the EuroQoL 5 dimension (EQ-5D) questionnaire. These evaluations were performed preoperatively and at 1 month and 3 months postoperatively. Results Performance-based and self-reported physical function and quality of life measures improved nonlinearly over time. Specifically, the 6WMT, TUG, gait speed, WOMAC-pain, WOMAC-function, VAS, and EQ-5D scores showed a significant improvement at 1-month post-TKA, whereas SCT, peak torque of the knee extensors and flexors, and WOMAC-stiffness scores showed gradual, but substantial, improvements over 3 months. There were between-group differences (unilateral and bilateral TKA groups) in the time course of the SCT, 6MWT, TUG, VAS, WOAMC-stiffness, and WOMAC-function results. Conclusion Patients who underwent critical pathway rehabilitation after TKA showed significant improvements in functional measurements during the first 3 months post-surgery. |
| first_indexed | 2024-03-12T19:52:12Z |
| format | Article |
| id | doaj.art-98872299b68d44c994966c1f10f7aeb8 |
| institution | Directory Open Access Journal |
| issn | 2234-0645 2234-0653 |
| language | English |
| last_indexed | 2024-03-12T19:52:12Z |
| publishDate | 2019-12-01 |
| publisher | Korean Academy of Rehabilitation Medicine |
| record_format | Article |
| series | Annals of Rehabilitation Medicine |
| spelling | doaj.art-98872299b68d44c994966c1f10f7aeb82023-08-02T03:04:49ZengKorean Academy of Rehabilitation MedicineAnnals of Rehabilitation Medicine2234-06452234-06532019-12-0143665066110.5535/arm.2019.43.6.6504128Functional Outcomes After Critical Pathway for Inpatient Rehabilitation of Total Knee ArthroplastyJong Hyun Kim0Bo Ryun Kim1Sang Rim Kim2Eun Young Han3Kwang Woo Nam4So Young Lee5Won Bin Kim6 Department of Rehabilitation Medicine, Jeju National University College of Medicine—Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University Hospital, Jeju, Korea Department of Rehabilitation Medicine, Jeju National University College of Medicine—Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University Hospital, Jeju, Korea Department of Orthopedic Surgery, Jeju National University College of Medicine—Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University Hospital, Jeju, Korea Department of Rehabilitation Medicine, Jeju National University College of Medicine—Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University Hospital, Jeju, Korea Department of Orthopedic Surgery, Jeju National University College of Medicine—Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University Hospital, Jeju, Korea Department of Rehabilitation Medicine, Jeju National University College of Medicine—Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University Hospital, Jeju, Korea Department of Rehabilitation Medicine, Jeju National University College of Medicine—Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University Hospital, Jeju, KoreaObjective To investigate functional outcomes after the application of a critical pathway for inpatient rehabilitation of total knee arthroplasty (TKA). Methods A total of 184 patients (57 males and 127 females; average age, 71.5±5.9 years) who underwent unilateral or bilateral TKA were included. The critical pathway included early, intensive individualized rehabilitation exercises. Patients completed the following performance-based physical function tests: the stair climbing test (SCT), 6-minute walk test (6MWT), and Timed Up and Go test (TUG) as well as measurement of isometric knee flexor and extensor strength of the operated knee, gait speed, and range of knee flexion and extension. Self-reported physical function and pain were measured using the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS), respectively, and self-reported quality of life was measured using the EuroQoL 5 dimension (EQ-5D) questionnaire. These evaluations were performed preoperatively and at 1 month and 3 months postoperatively. Results Performance-based and self-reported physical function and quality of life measures improved nonlinearly over time. Specifically, the 6WMT, TUG, gait speed, WOMAC-pain, WOMAC-function, VAS, and EQ-5D scores showed a significant improvement at 1-month post-TKA, whereas SCT, peak torque of the knee extensors and flexors, and WOMAC-stiffness scores showed gradual, but substantial, improvements over 3 months. There were between-group differences (unilateral and bilateral TKA groups) in the time course of the SCT, 6MWT, TUG, VAS, WOAMC-stiffness, and WOMAC-function results. Conclusion Patients who underwent critical pathway rehabilitation after TKA showed significant improvements in functional measurements during the first 3 months post-surgery.http://www.e-arm.org/upload/pdf/arm-2019-43-6-650.pdfarthroplastykneeosteoarthritisrehabilitationcritical pathways |
| spellingShingle | Jong Hyun Kim Bo Ryun Kim Sang Rim Kim Eun Young Han Kwang Woo Nam So Young Lee Won Bin Kim Functional Outcomes After Critical Pathway for Inpatient Rehabilitation of Total Knee Arthroplasty Annals of Rehabilitation Medicine arthroplasty knee osteoarthritis rehabilitation critical pathways |
| title | Functional Outcomes After Critical Pathway for Inpatient Rehabilitation of Total Knee Arthroplasty |
| title_full | Functional Outcomes After Critical Pathway for Inpatient Rehabilitation of Total Knee Arthroplasty |
| title_fullStr | Functional Outcomes After Critical Pathway for Inpatient Rehabilitation of Total Knee Arthroplasty |
| title_full_unstemmed | Functional Outcomes After Critical Pathway for Inpatient Rehabilitation of Total Knee Arthroplasty |
| title_short | Functional Outcomes After Critical Pathway for Inpatient Rehabilitation of Total Knee Arthroplasty |
| title_sort | functional outcomes after critical pathway for inpatient rehabilitation of total knee arthroplasty |
| topic | arthroplasty knee osteoarthritis rehabilitation critical pathways |
| url | http://www.e-arm.org/upload/pdf/arm-2019-43-6-650.pdf |
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